UnitedHealth says it's under federal investigation for Medicare fraud
The health insurer said it is complying with the Department of Justice's criminal and civil investigation

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UnitedHealth Group said Thursday that its Medicare business is under investigation by the Department of Justice.
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The health insurer said it is complying with the department’s formal criminal and civil investigation into its participation in the Medicare program and that it initially reached out to the DOJ after seeing media reports centering around investigations into “certain aspects” of UnitedHealth’s Medicare practices.
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The company added that it launched its own third party review of “policies, practices, and associated processes and performance metrics for risk assessment coding, managed care practices, and pharmacy services.”
In May, the Wall Street Journal reported that the Department of Justice was conducting a criminal investigation into the company’s Medicare billing practices. The Journal had previously reported in February that the company was under a civil DOJ investigation for its Medicare practices.
A week after the May report, The Guardian reported that UnitedHealth allegedly deployed in-house medical teams to around 2,000 nursing homes and offered cash incentives to limit hospital transfers to cut costs under its Medicare Advantage program. Internal records viewed by the newspaper and whistleblower accounts suggest that treatment for some residents in urgent need of hospital care was delayed or even denied, resulting in long-term damages.
Bonuses were reportedly tied to hospitalization rates, with one key metric labeled “admits per thousand,” and high rates meant no financial rewards. Nursing home staff were allegedly encouraged to change patients’ code status to “do not resuscitate” and use access to health records to help target potential enrollees.
In a statement provided to Quartz, UnitedHealth said that as part of a multiyear investigation, the Department of Justice investigated these claims, interviewed witnesses, reviewed thousands of documents, and ultimately “declined to pursue the matter” after finding “significant factual inaccuracies.”
UnitedHealth previously suspended its 2025 financial guidance, blaming unexpectedly high medical costs from new Medicare Advantage enrollees.
Its stock dropped more than 1% after the news broke in morning trading.
—Shannon Carroll contributed to this article.